EP1201266A1 - Methode zur Datenprogrammierung einer Reizvorrichtung - Google Patents

Methode zur Datenprogrammierung einer Reizvorrichtung Download PDF

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Publication number
EP1201266A1
EP1201266A1 EP00203742A EP00203742A EP1201266A1 EP 1201266 A1 EP1201266 A1 EP 1201266A1 EP 00203742 A EP00203742 A EP 00203742A EP 00203742 A EP00203742 A EP 00203742A EP 1201266 A1 EP1201266 A1 EP 1201266A1
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EP
European Patent Office
Prior art keywords
stimulation
data
sequences
sequence
window
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP00203742A
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English (en)
French (fr)
Inventor
Milos R. Popovic
Thierry Keller
Ion P. Pappas
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DJO Global Switzerland SARL
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Compex SARL
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Publication date
Application filed by Compex SARL filed Critical Compex SARL
Priority to EP00203742A priority Critical patent/EP1201266A1/de
Publication of EP1201266A1 publication Critical patent/EP1201266A1/de
Withdrawn legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36003—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of motor muscles, e.g. for walking assistance
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/30—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/40—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the management of medical equipment or devices, e.g. scheduling maintenance or upgrades
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • G16H10/65—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records stored on portable record carriers, e.g. on smartcards, RFID tags or CD

Definitions

  • the invention relates to a method for programming stimulation data.
  • electrical for a neuromuscular or functional electrical stimulation device in an installation which includes a computer station with a management program electrical stimulation data and graphical user interface, at least one reading and writing device in communication with the computer station, and at minus a storage medium placed in the device for storing in memory personal electrical stimulation data.
  • the invention also relates to a data programming installation. electrical stimulation in particular for the implementation of the method.
  • the installation includes a computer station having a central processing unit electrical stimulation data management program and interface graphical user, at least one communication reading and writing device with the computer station, and at least one storage medium placed in the device for storing personal electrical stimulation data.
  • a graphical interface computer station for a programmer. The latter can thus view the sequences of electrical pulses that he introduces and that he records for a specific user.
  • the stimulation data sequences composed in the programming installation are complex to operate a defined movement of a member of the human body using an electrical stimulation device. Use of such an installation is therefore advantageously suitable for medical use or therapeutic for disabled or injured people.
  • the electrical stimulation data used in the present invention concern both textual data to be displayed on a station screen computer or on a screen of a stimulation device, sound data warning data relating to sensors or actuators as as user interaction device, channel selection data from pacing, repeat loop data from pacing sequences, connection data in stimulation sequences, ramp data amplitude or pulse width and amplitude, frequency, width of electrical pulses.
  • Neuromuscular or functional electrical stimulation devices can be used for a variety of purposes. They are also used for strengthening the musculature through power training programs or endurance, to maintain or increase the margin of movement, to facilitate or re-educate voluntary motor functions, or for other purposes.
  • the device used as a neuroprosthesis in this medical field is defined as a functional electrical stimulation device.
  • the generation of electrical pulses by said device for managing the movements of a member of the human body is planned for a long period of activity.
  • the reader may refer for more details of the neuromuscular electrical stimulation, which part is functional electrical stimulation, the Practical Guide 3rd edition entitled "Neuromuscular Electrical Stimulation" LL Baker, DR McNeal, LA Benton, BR Bowman RL Waters published by Los Amigos Research & Education Institute, Inc. in 1993.
  • the arrangement of stimulation sequences of all stimulation channels a neuroprosthesis used to operate a movement of a hand or legs by example requires complex programming of all data from electrical stimulation. Therefore, it is proposed to use a graphical interface to view the electrical stimulation data that a programmer must compose.
  • a muscle paralyzed is a muscle that has a deficiency or lack of function motor, most often due to peripheral or central nerve damage. If the nerve damage is mainly found in the central nervous system, the peripheral nervous system remains intact. This allows the paralyzed muscle, but not pissed off, being stimulated like a healthy muscle by means of stimulation neuromuscular or functional. If a muscle is normally innervated, it is stimulated by excitation of his motor nerve for example by means of impulses rectangular biphasic current with short durations of width between 15 to 350 ⁇ s. If, on the other hand, the muscles are nervous, the rectangular impulses must be longer in duration, for example between 50 to 200 ms. These impulses of long durations should not in principle be biphasic.
  • electro-stimulation especially for use in this medical field, is to be able to create action potentials in cells stimulable. To get an excitement, it is not the form of the impulse that counts, but rather the amount of electrical charges. This rule remains valid if the total duration of electrical pulses remains the same.
  • Maintaining room for movement and preventing imbalance muscle and fiber restriction joint contraction is a problem constant clinical treatment of paralyzed patients, for example.
  • an installation comprising a programming station connected to a neuromuscular electrical stimulation device has been described in particular in the Patent EP 0 197 889 of the Applicant.
  • the installation includes a programmer, in which a therapist for example initially programs sequences of stimulation that he memorizes on a smart card inserted in a reading device and writing the programmer. Then, the smart card is inserted into a other device for reading and writing the stimulation device to enable it read the stimulation data recorded on the smart card and thus provide the electrical pulse trains at the electrodes.
  • a disadvantage of this installation is that the first operation loading stimulation data onto the smart card, which is personalized to the patient to be treated, must be performed on the programmer. This requires continuously using the programmer and the stimulation device to adapt all parameters and stimulation sequences specific to a patient.
  • patent application WO 98/55177 describes an electrical stimulation system functional in order to allow movement of paralyzed body members or injured by a neuroprosthesis.
  • the system includes a station computer in which electrical stimulation data is entered and recorded, a portable stimulation device receiving stimulation data established in the computer station, and system memory, such as media recording.
  • the system memory contains a data file which, under command of a system program, produces at least one electrical stimulation pattern for the muscles to be stimulated.
  • a memory table records information from generation of commands and stimulation patterns, and separately from characterization for each electrode. Patterns of muscle movement required to be stimulated are developed and stored in the system to define at least three desired movements.
  • a data record should be performed both in a station memory and in a device memory stimulation.
  • the visualization of all stimulation data and characteristics of the electrodes used depends on stimulation tests performed on a patient.
  • a major drawback of this system is the programming of reasons for stimulation to be able to impose a series of movements on a member of the human body by electrical stimulation sequences. A list of reasons for movements must be established in order to subsequently allow to combine some of these reasons to move the desired member.
  • a first pair of electrodes receives a first stimulation sequence to operate a muscle contraction. Then from which, an identification is attributed to the first sequence generated. A second stimulation sequence is supplied to other electrodes to contract a other muscle. Then what an identification is assigned to the second sequence. This recording of all stimulation sequences on a support registering for creating this list takes too long, which is a disadvantage.
  • the aim which the invention proposes to resolve consists in facilitating and accelerating programming complex electrical stimulation data sequences in a programming installation with a graphical user interface to overcome the drawbacks of the methods and devices of the prior art.
  • Another object which the invention proposes to resolve consists in recording sequences of complex stimulation data on a storage medium in a reduced memory space to be interpreted in a stimulation device electric by overcoming the drawbacks of the devices and methods of the prior art.
  • An advantage of the method is to be able to create one or more sequences of stimulation data on the graphical interface of the computer station so that a programmer can quickly and easily establish suitable sequences for patient to be treated.
  • an assembly of unitary blocks of stimulation each represented by a specific icon or pictogram in a central processing unit library is realized.
  • a main window of the graphical user interface is therefore provided in which one or more rows are to be completed with unit blocks of stimulation functions for each sequence of stimulation data of a channel corresponding stimulation.
  • the icons representing the unitary stimulation function blocks bear graphics that immediately and intuitively allow a programmer to quickly build arbitrary stimulation sequences of each stimulation channel.
  • a color code can be applied to the icons depending on whether they are intended for one or more channels of stimulation.
  • This series of unit blocks of each sequence is then coded for be able to be saved on a storage medium, which is advantageously a smart card, inserted in the reading and writing device.
  • This device reading and writing can be that of an electrical stimulation device neuromuscular or functional.
  • the coding of the unit blocks consists in assigning at least an identification number for each block configured to occupy only one reduced memory space in the storage medium, in particular the memory card chip.
  • the stimulation device receiving the card must have a management program complementary to that of the computer station. This complementary program allows him to find the blocks units according to their identification number for generating pulses to be supplied to the stimulation electrodes.
  • the card once programmed, can be placed in any electrical stimulation device with program additional management so that you can quickly change the device previous device malfunction.
  • Another advantage of said method consists in being able to program successively several storage media, such as smart cards, each intended to be placed in a functional electrical stimulation device.
  • One of the supports is programmed as a master with data from synchronization so that one of the interconnected stimulation devices receiving the storage media acts as a master while other devices act as a slave.
  • Combining or paralleling several devices stimulation can be useful when it is necessary to place a large number stimulation electrodes on several muscles to be electrically stimulated during the management of movements of members of the human body.
  • the storage media each inserted in one of the interconnected stimulation devices, could be programmed simultaneously.
  • several sets of stimulation data sequences are composed on the computer station for all interconnected stimulation devices. In sequence games, it must be specified which device should play the role of master by compared to other devices.
  • the speed of establishment and recording of data sequences of electrical stimulation by the process allows rapid use of functional electrical stimulation in the early stages of rehabilitation of a paralyzed or injured subject.
  • This programming method is therefore advantageously used for multiple applications, such as rehabilitation, development of neuroprostheses, the neurological evaluation of a patient.
  • it is also intended to be used for hospitals, for research centers and for biology laboratories.
  • the electrical stimulation device can potentially be used in combination with central nerve repair techniques to rehabilitate nerve pathways and for generating a movement profile.
  • the central unit include a library of unitary function blocks stimulation each represented by a specific icon in a window library in the graphical user interface, said blocks being able to be drawn from the library window and introduced into a main interface window graph for the composition of at least one sequence of stimulation data electrical of at least one stimulation channel of an electrical stimulation device neuromuscular or functional, and in that data entry means of the computer station allow you to configure certain unit blocks of the sequence and / or adapt stimulation parameters, displayed in at least a window for adjusting parameters on the graphical user interface, to the execution of unit blocks of stimulation functions placed in the sequence of stimulation data.
  • Radio Cards include all processing data. They can be inserted in any device neuromuscular or functional electrical stimulation with management program stimulation data complementary to the station management program computer.
  • the following description for programming stimulation data will be preferably based on a programming facility which includes a station working with stimulation data management program and user interface graphic, at least one reading and writing device of a stimulation device neuromuscular or functional in communication with the station computer, and at least one storage medium, such as a smart card, insert into the read and write device to store data of personalized electrical stimulation.
  • Electronic components of the elements of the installation will not be described in detail as they are part of the knowledge general of a person skilled in the art in this technical field. However, the steps of the method of programming electrical stimulation data using the installation will be detailed and visualized with reference to Figures 5 to 13 in the continuation of the description.
  • the installation for programming data from electrical stimulation consists of a computer station 1 with user interface graphic, of an electric cable 5 connected to an output 5a of the computer station 1 and to an input of a portable neuromuscular electrical stimulation device or functional 2, and at least one smart card 8.
  • Said card as a support for memory, is inserted into a reading and writing device of the device to receive coded stimulation data sequences from the computer station 1. Each sequence established for each stimulation channel is recorded in memory positions determined in the smart card 8.
  • a data management program is installed in the computer station 1 to be able to compose and translate sequences of data from stimulation.
  • Said computer station 1 is conventionally composed of means of data entry, which are represented by a mouse 3a and by a keyboard 3b connected to corresponding inputs of the station, and a display screen 4 of the graphical user interface.
  • the graphical user interface of the station computer 1 therefore allows a programmer to define easily and intuitively arbitrary sequences of stimulation data. Said sequences are defined for each stimulation channel of an electrical stimulation device functional in a main window of the interface. This main window, as well that the other windows linked to the main window, will be explained in detail at from Figures 5a and 5b.
  • the programmer therefore composes the stimulation data sequences on screen 4 of the graphical interface of computer station 1 according to the channels stimulation of an electrical stimulation device 2. These established sequences are translated into coded stimulation sequences. The coded sequences are then sent in series one after the other to the reading and writing of the switched-on device to save them on the smart card 8. The order of the transmitted sequences depends for example on the number of each stimulation channel.
  • the coding of the stimulation data sequences allows reduce the size of the data to be recorded on the smart card so that it occupy only a small amount of memory on the card.
  • the portable neuromuscular or functional electrical stimulation device 2 includes a display screen 7 on which graphs or values or texts can be displayed according to the programming, for example, sequences stimulation on the smart card 8.
  • the device also includes buttons 6 of control or adjustment of stimulation parameters, outputs to connect stimulation electrodes and inputs for sensor measurements or actuator commands for user interactions, not shown in the Figure 1a.
  • buttons 6 of control or adjustment of stimulation parameters outputs to connect stimulation electrodes and inputs for sensor measurements or actuator commands for user interactions, not shown in the Figure 1a.
  • only the device's read and write device is used to record electrical stimulation data sequences on the smart card 8.
  • the stimulation device electric 2 is preferably the device called Compex2 supplied by the company Compex S.A. located in Ecublens, Switzerland.
  • This electrical stimulation device 2 includes four stimulation channels and must have a program of data management complementary to the program of the computer station 1.
  • any other electrical stimulation device can obviously be used as far as it includes a device for reading and writing a medium removable storage 8 and a stimulation data management program complementary to the computer station program 1.
  • the data sequences are translated by said program. management in coded sequences to be recorded on the card.
  • the stimulation device is turned on to interpret or translate inversely coded sequences of the smart card using the management program complementary.
  • the stimulation data management program is notably relating to the stimulation parameters to facilitate the introduction of said data stimulation.
  • an adaptation of the stimulation parameters can be performed following measurements made by sensors placed at the muscles stimulated electrically or in the muscles of voluntary contraction. These measures allow optimal management of the movement of a stimulated muscle electrically. Certain sensors or actuators, on the other hand, serve as a device user interaction, during the execution of the sequences stored on the card, for controlling activation of the stimulation device.
  • the functional electrical stimulation device is preferably a neuroprosthesis intended in particular for the rehabilitation of disabled subjects or accident victims to enable them to regain lost bodily functions or missing.
  • This neuroprosthesis provides them with independence from their unnecessary movements other people's help in their activities daily.
  • the smart card 8 is therefore programmed according to the method of the invention with encoded stimulation data sequences which are, in this case, complex to be used in such a neuroprosthesis.
  • Adjustment of the amplitude of the current or the voltage of each pulse electric allows you to choose the number of muscle fibers to recruit during the stimulation.
  • one portion concerns a strong variation in torque with increasing current amplitude.
  • Another portion in particular from 60 mA, defines that the force torque reaches a ceiling, which means that all fibers have been recruited.
  • a relationship can also be made between the torque and duration of the imposed current pulses.
  • FES Fieldal Electrical Stimulation
  • Muscle contraction is operated by generating action potentials in the motor nerves to cause said contraction. It is of importance essential that the subject has intact secondary motor neurons to be able to impose electrical stimuli on it that can act on the contraction muscular.
  • Muscles can be stimulated using pulses of tension or monophasic or biphasic current with alternating anode if possible and the cathode during stimulation.
  • biphasic current pulses As the use of monophasic current pulses on the skin has the disadvantage of inducing risks of burns, it is recommended to generate usually biphasic current pulses so that the average of the current be zero.
  • This type of biphasic pulse resolves the phenomenon of fiber polarization.
  • biphasic rectangular pulses In addition, to have the highest contraction force possible it is preferred to generate biphasic rectangular pulses in which the positive phase is equivalent to the negative phase.
  • This impulse electric biphasic rectangular allows with the same intensity to have a better spatial recruitment of motor units. Account must therefore be taken of the form of impulses to be imposed on the muscles specifically for the adaptation of movements of a member wearing a neuroprosthesis.
  • Pulse amplitude progression ramps can be also programmed to gradually select fibers muscle or nerve electrically stimulated rather than exciting all motor units abruptly.
  • a graph of a linear variation amplitude versus time is shown in Figure 9b.
  • the impulses of constant frequency currents are biphasic, symmetrical and not alternating.
  • the amplitude of the pulses which can be chosen up to a maximum value of 100 mA, varies from an AMP1 value to an AMP2 value and finally to an AMP3 value in a defined transition period.
  • the introduction of the constants of variation amplitude will be shown with reference to Figure 9a in the following description.
  • FIG. 8c a graph of a pulse width variation as a function of time is shown in Figure 8c. Pulse widths are varied from a PW1 value to a PW2 value and finally to a value PW3. It is more important to specify the phase duration of each pulse rather than the total duration of the pulse.
  • the stimulation of the motor points can be carried out by electrodes of surface or subcutaneous electrodes that are capable of delivering charges electrics at motor points more selectively than the electrodes of area.
  • said surface electrodes can be placed quickly without surgical intervention on the skin of a patient which constitutes a net advantage in the case of the rehabilitation of a patient.
  • portable electrical stimulation devices are used to activate their muscles made inactive.
  • Such a stimulation device can be used for example for the action of the muscles of one hand for gripping objects.
  • a window for adjusting parameters is provided to choose the type of interaction of a user and to adapt the measurements of a analog type sensor as shown in Figures 10a, 10b and 11.
  • Such neuroprostheses receiving a storage medium, including the coded stimulation data sequences were recorded in the facility can also be used to order sequences of electrical stimulation of the leg muscles to allow the subject to walk.
  • the computer station orders the reading of the support, which includes previously encoded stimulation data sequences stored.
  • the read command allows viewing on the main window of graphical user interface stored stimulation data sequences on the map.
  • the parameter data adapted in windows can also be viewed to check and / or modify these data.
  • the computer station can store the stimulation data read from the menu.
  • FIG. 1b a second embodiment of the installation especially for programming multiple 8 and 8 'smart cards is shown.
  • the same elements in this figure 1b bear identical reference signs to those of Figure 1a.
  • 8 and 8 'smart cards can be pre-programmed for be used in several functional electrical stimulation devices interconnected 2 and 2 '.
  • the computer station 1 which notably comprises a display screen 4 of the electrical stimulation data and of the means data entry 3a and 3b, is connected from an output 5a of the station by a electric cable 5 to a first electrical stimulation device 2.
  • This first electrical stimulation device 2 is itself connected by an electrical cable 5 'to a second electrical stimulation device 2 '.
  • the electric cables or data bus 5 and 5 include several wires devices for transferring stimulation data between the computer station and interconnected stimulation devices. This data transfer is therefore no longer carried out by serial way as in the first embodiment, because the serial communication is only possible between two devices interconnected.
  • Each device has a 7 and 7 'display screen on which are displayed amplitude, frequency and / or pulse width, text or electrical stimulation graphics.
  • a first smart card 8 is inserted in the read and write device of the first device 2, and a second card to chip 8 'is inserted in the read and write device of the second device 2'.
  • sequences of pacing data is composed using the graphical user interface of computer station 1 for all stimulation channels of electrical stimulation 2 and 2 '. These sequences are translated into sequences of coded stimulation data which each include in addition to indications of parameters adapted for each channel, as well as for each device.
  • coded sequences are sent by the data bus 5 towards the read and write device of the first device where the coded sequences intended for this device are recorded on the smart card 8.
  • the others coded sequences are transmitted via another 5 'data bus between the first device 2 and the second device 2 'to the reading and writing device of the second device 2 ′ where these coded sequences are recorded on the smart card 8 '.
  • a selection between master mode and slave mode can be determined for each set of stimulation data sequences intended for each device.
  • the smart card 8 can record the master mode for require the first electrical stimulation device 2 to play the role of master for synchronize all stimulation channels of other interconnected devices, which must play the role of slave.
  • Smart cards 8 once programmed with the master mode or slave mode, are subsequently inserted in several devices of interconnected stimulation.
  • the first stimulation device with the card master plays the role of master to synchronize all other devices interconnected which thereby play the role of slave.
  • This possibility to program the sequences with the master mode or slave mode advantageously makes it possible to combine or set up parallel several interconnected stimulation devices synchronized by the device master.
  • These interconnected devices serve mainly as a neuroprosthesis to order movement of body members through multiple pairs stimulation electrodes placed on motor points of muscles to be stimulated electrically.
  • These electrical stimulation devices can allow in combination with central nerve repair techniques to rehabilitate the pathways nerve or establish movement patterns.
  • FIG. 1c a third embodiment of the installation of programming is shown in which the transmission of stimulation data 9 between the computer station 1 and the stimulation device 2 is done by means transmitting and receiving wireless signals.
  • These means of transmission and reception are represented only by an antenna 9a on the computer station and a antenna 9b on the stimulation device 2, but they will not be explained in detail because they are part of the general knowledge of a person skilled in the art.
  • FIG. 2 the electronic blocks of the computer station 1 are represented for the implementation of the method for programming the sequences of stimulation data according to the invention.
  • Computer station 1 which can be a personal workstation, includes a central data processing unit 10.
  • the unit is made up mainly microcontroller means 12 for processing and managing all stimulation data, and storage means 11.
  • These means memory are composed in particular of a memory 11a of program management of stimulation data and memory 11b of a block library of stimulation functions.
  • the storage means 11 include also a memory, not shown in Figure 2, for storing stimulation data when composing data sequences of stimulation or reading of stimulation data sequences from a memorization previously programmed.
  • the program stored in memory 11a to allow processing of stimulation data from microcontroller means 12, as well as the library unit blocks of stimulation functions 11b are for example placed on the computer station hard drive. This thus preserves the management of stimulation data even during a power interruption computer station 1.
  • the computer station 1 also comprises means for introducing data 3, which have already been shown in FIGS. 1a to 1c, a user interface graphic linked to the central processing unit 10 and an input and output interface of data signals 13 connected to the microcontroller means 12.
  • the interface graphic includes in particular a display drive block 4a managed by the central unit and a display device 4.
  • the data signals of the interface input and output 13 are transmitted by serial 5 to the stimulation device electric 2 for recording coded stimulation data sequences on the smart card 8.
  • the coded sequences are placed one after the others for serial transmission between the computer station and the reading and writing of the stimulation device.
  • the apparatus further includes sensor data inputs 15 and electrode connection outputs of stimulation 14.
  • the windows appearing on the display device 4 of the station computer 1 can be selected for example by a mouse pointer data entry means 3. Values or texts can be also entered by the keyboard data entry means 3 in determined positions of the composition data sequence windows of stimulation.
  • This programming of the stimulation data sequences on GUI requires installation of LabView runtime driver (version 5.1) for example on a personal workstation 1.
  • FIG. 3 the electronic blocks of the stimulation device 2, serving in a first intermediary phase to the recording of sequences of stimulation data coded on the smart card 8 are shown.
  • the portable electrical stimulation device 2 is composed of an interface input and output 19 of electrical stimulation signals in connection with the computer station via serial port 5, a microcontroller 16 connected to the interface and processing the sequences of stimulation data, of a memory with program of management of stimulation data 20 linked to microcontroller 16, of a memory of data storage 21 of the microcontroller 16, of a keyboard 6 for the introduction of stimulation or operating mode parameters for the microcontroller 16 and a read and write device 18 receiving a smart card 8 for recording of encoded stimulation data sequences.
  • Blocks stimulation device electronics 2 are powered by an energy source 17 which may be a rechargeable battery.
  • the data processed in the microcontroller 16 when the the stimulation device 2 can be displayed on a display device 7 according to a selection made on one of the keyboard buttons 6.
  • the stimulation device is engaged only to allow the reading and writing device 18 to transfer coded stimulation data sequences from the station computer on the smart card 8 so that they are stored.
  • the smart card 8 is inserted into a stimulation 2 which includes a stimulation data management program complementary to that of the computer station.
  • This management program which is software written in assembly language is stored in memory at program 20 to allow the microcontroller 16 to translate the sequences coded reads from the smart card 8.
  • Each unit block of the coded sequences, registered on the card under at least one specific identification number, is recognized by the microcontroller 16, as well as the suitable parameters linked to the blocks of stimulation functions.
  • trains electrical pulses are generated by output stage 24 to at least one pair stimulation electrodes 14 of a stimulation channel.
  • the coded sequences of the smart card 8 can be saved in a memory 21 when setting the stimulation device.
  • the portable functional electrical stimulation device 2 includes also inputs for signals from sensors 15 or actuators.
  • the measurement signals are supplied to a signal processor 25 from sensors 15 or actuators so that the microcontroller 16 processes the data supplied by the processor 25.
  • the microcontroller takes into account based on the data management program and coded stimulation data sequences from the smart card 8 which variations or commands must be operated for the generation of trains of electrical pulses from the output stage 24.
  • the measurements made by the sensors or the actuators can impose a change in amplitude of the pulses electric in order to modulate the force or the force couple of a neuroprosthesis for the seizure of objects for example.
  • the smart card 8 which is well known in this technical field, includes an interface 30 for input and output of data from stimulation by a connection 28 with the reading and writing device of the device electrical stimulation. Stimulation data sequences are transmitted from the interface 30 to the microprocessor 31 and to the EEPROM memory 32. The addresses positions of memory 32 where the various data of the sequences are managed by the microprocessor 31.
  • the stimulation sequences programmed by the user and the control layouts can be saved entirely on the smart card 8 which can be read and executed by any stimulation device for example of type Compex2.
  • the information of the whole sequences is on the smart card and not in the stimulation device, which simplifies its handling. For any change program with the same stimulation device, just change only microchip.
  • the memory space of the smart card 8 being relatively small (2 kbytes), the sequences are coded to be memorized and placed in positions determined from EEPROM memory 32. At least one identification number is assigned to each unit block of configured stimulation functions placed in each sequence of stimulation data. Block identification numbers configured are saved on the smart card in determined positions so that the coded sequences occupy only a reduced space in the memory of the card.
  • Half of the memory on the smart card is used to save including user data, stimulation parameters, ramps, constants and other data.
  • the corresponding memory positions are defined by the addresses 6000 to 63FF in hexadecimal.
  • the remaining memory space on the smart card is used to store the unit block sequences, i.e. block identification numbers units configured for each channel.
  • the corresponding memory positions are defined by addresses 6400 to 67FF in hexadecimal.
  • the stimulation device receiving the programmed card knows how to find the function of each unit block configured and memorized using a program management of stimulation data complementary to that of the computer station.
  • Treatments using these electrical stimulation devices neuromuscular with their personalized treatment program card can be make it to the patient's home. However, monitoring of treatment must be done by a therapist so that he can see the evolution of treatment of the bodily parts accidented or weakened by the stimulator or the stimulation prosthesis electric.
  • Figures 5a and 5b represent each a main GUI window with examples different from established stimulation data sequences.
  • stimulation data sequences were composed for the first and the fourth stimulation channel, whereas in FIG. 5b sequences of Stimulation data was composed for all channels in a similar fashion.
  • the main window 40 which appears on the screen of the user interface graphic when starting up the computer station with the program management of stimulation data, allows to compose several sequences of stimulation data for several stimulation channels of a electrical stimulation. In this case, only four sequences of stimulation data are visible and sufficient for the four channels of the electrical stimulation device, such as the Compex2 device.
  • Each sequence of stimulation data is arranged in a row horizontal 41, while each stimulation channel with its sequence is shown vertically on the main window.
  • the rows of stimulation data sequences each include a certain number of empty cells 42, for example 254 cells, of which only 8 are visible on the main window 40. All the boxes of each sequence can however be viewed by moving a graphic cursor 47 corresponding using a pointer operated by the computer mouse.
  • Said row boxes can be completed successively, from the first box on the left, by unitary blocks of stimulation functions serving to the arbitrary composition of the stimulation data sequences.
  • These blocks unitary units 51 are taken from a library window 50 of unitary blocks of stimulation functions, seen in figure 6, which appears by clicking in the sequence of a channel.
  • the graphic keys 49 of each sequence By pressing one of the graphic keys 49 of each sequence, it is possible to successively insert selected unit blocks 51 in boxes voids 42 of each sequence for their composition.
  • the keys 49 allow also to delete a unit block introduced in a determined position or to delete the last block in the sequence. Any data sequence from stimulation must end with the end of sequence unit block (END).
  • END end of sequence unit block
  • the empty boxes 42 are preferably supplemented by this icon at the end of sequence.
  • Unit blocks of stimulation functions forming part of a library of unit blocks are each represented by an icon 51 representative of the function of a unit block in a library window 50 of unit blocks shown in Figure 6.
  • icon 51 representative of the function of a unit block in a library window 50 of unit blocks shown in Figure 6.
  • this library window at least 56 icons represent all the unitary blocks of stimulation functions. However, others icons could still complement the library.
  • the icons allow you to immediately recognize which category of function is hidden in such or such unitary block of functions.
  • a color code of background of icons can still be adopted to define if a unit block is suitable for all channels in the same way or if it can be adapted for each channel differently. It can be considered to use the green background color for the blocks which are adapted in the same way for all channels, and the color of blue background for unit blocks which are adapted differently from one channel to another.
  • the icons may be automatically copied into empty boxes 42 in rows 41 of the window main 40 by a well-known drag and drop method ("drag and drop method "in English terminology) from the graphical user interface or by press an insertion key 49 explained above. So the sequences of stimulation data is quickly composed by copying the desired icons from the library window. Also as each icon 51 defines visually the function of the unit block, it is easy and intuitive to place them successively in each row to establish complex sequences of personal stimulation data desired.
  • Unit blocks of stimulation functions placed in rows 41 to establish stimulation data sequences are configured in the window main 40. Positions 48 in each box 42 of rows 41 allow to enter values for example to configure certain unit blocks 51.
  • Each configured block is defined by at least one specific identification number, which is for example between 0 and 255, when translating the sequences of stimulation data, so that said block occupies a determined memory position. This memory position is also a function of the stimulation channel number during the recording of coded sequences on the smart card.
  • buttons 43, 6 in number shown below on the left part of the main window 40, can be pressed using a computer mouse pointer to open an adaptation window corresponding parameters to be adapted.
  • Parameter adaptation windows relate for example to user information, ramps and pulse width constants, amplitude and frequency constants, analog amplitude controls based on sensor measurements, user interactions and text data.
  • buttons 44 of the main window 40 can be moved graphically by the pointer to define the stimulation mode. It is possible to choose the form of the electrical pulses, that is to say monopolar or bipolar, asymmetrical or symmetrical, alternating or not alternating.
  • the composition of pacing data sequences can be done in time-based mode or in pulse-based mode. Preferably, the time-based mode is chosen.
  • a master mode or a slave mode can be chosen. The master or slave mode allows to define the priority data to be stored on one or the other smart card to be programmed. Well heard, each duration selected or entered in the main window is translated into microcontroller means for transmission.
  • each row it is possible introduce a default amplitude value and maximum width values of pulses and amplitude.
  • a default pacing rate can also be introduced for all stimulation channels.
  • the stimulation data sequences are completed and the parameters have been adapted for the execution of the unit blocks of the sequences, it it involves translating the sequences of stimulation data into coded sequences.
  • a graphic button 46 for programming the smart card is pressed to save coded sequences and parameters suitable for determined positions of the card memory.
  • Data transmission between the computer station and the stimulation device is preferably done by channel serial.
  • a dialog box For programming the card, a dialog box, not shown, appears by pressing one of the buttons 46. This box stipulates that the the stimulation device for recording the sequences coded on the card to chip, connecting the data cable, and verifying that a card has been inserted into the device's reading and writing device.
  • An error box also appears for the transmission stimulation data. This box indicates if the communication with the device of stimulation failed, in case the device was turned off or the cable was not connected or no card was inserted in the device.
  • a box shows the advance of the unloading procedure of the program and indicates that the smart card has been successfully programmed.
  • buttons 46 makes it possible to control the reading of a preprogrammed card inserted in the stimulation device set market. This allows in particular to view on the screen of the computer station the data from the preprogrammed card so that it can be changed, for example.
  • the unit blocks of stimulation functions are divided into five categories which are explained with reference to Figures 7a to 7e showing the icons corresponding blocks. These categories relate to stimulation blocks, loop blocks, general purpose blocks, special purpose blocks, and blocks interaction of the user with the connection blocks in the sequences.
  • the first row of unit blocks relate to ramps ascending and descending A and B pulse width as possible to adapt in a ramp adaptation window 60 seen in FIG. 8a.
  • said ramp adaptation window 60 is opened by selecting the second button Figure 43 of the main window seen in Figures 5a and 5b.
  • FIG. 8b shows a window for editing a ascending ramp in which 16 points are drawn or introduced by means of data entry. To have a downward ramp based on the ascending ramp, the points of the descending ramp are traversed in time in the opposite direction of the ascending ramp.
  • the value of the pulse widths can be defined up to 16 ms in steps of 1 ⁇ s.
  • the unit block representing one or the other of ramps A and B can be configured in the main window.
  • the duration of ramp A or B can be selected between 0.1 and 3.2 s in 0.1 s steps. For generate such a ramp, 16 different points describe the ramp and its profile as explained above.
  • the program skips some of the points entered. For example, if the selected duration is 1 s, points 2, 3, 5, 6, 8, 10, 11, 13, 14 and 16 of the curve are executed.
  • the program repeats a few points twice.
  • the points, which repeat twice, are arithmetically distributed similarly to what the program performs within the range of 0.1 at 1.6 s. Instead of omitting values, some of these values are therefore repeated twice. For example, for a selected duration of 2.2 s, points 1, 1, 2, 3, 4, 4, 5, 6, 7, 7, 8, 9, 9, 10, 11, 12, 12, 13, 14, 15, 15 and 16 of the curve are executed.
  • the identification numbers from 0 to 31 for each channel are allocated according to the number of points selected during the configuration of the corresponding unit block. For the descending ramp, these are the identification numbers 32 to 63 which are assigned. For ascending ramp B, this are the identification numbers 64 to 95 that are assigned. For the ramp descendant B, the identification numbers 96 to 127 are assigned. It is very clear that the identification number assigned to one of the unit ramp blocks is placed in a memory register of the smart card also relating to the number of the channel in question.
  • Assigning identification numbers to unit blocks of ramps pulse width offers a wide variety of possible configurations of pulse width ramps based on an ascending or descending ramp for each stimulation channel. As the sequences are defined with the identification numbers of the configured blocks to be saved on the card, this allows reduce the memory space required for complex coded sequences.
  • the second row of unit blocks relates to constants A, B, C and D four pulse widths per channel.
  • the values of pulse width constants of each channel are introduced into positions determined next to the PWA, PWB, PWC and PWD references in the window visible in Figure 8a. These constant values can therefore be different from one channel to another.
  • Each unit block of pulse width constants can be configured in the main window 40, visible in FIGS. 5a and 5b, by entering values time (in a time-based mode) ranging from 0.1 s to 25.5 s. By setting a time value, it is imposed that the current pulses must have a width of pulses as a function of the constant fixed during the specified duration.
  • each identification number can define the configuration of each block of constants by adding the specified durations of each identification number (binary addition).
  • Each identification number defines a duration which is a multiple of two or a division by two of the duration of the neighboring identification number.
  • the number durations are 0.1 s, 0.2 s, 0.4 s, 0.8 s, 1.6 s, 3.2 s, 6.4 s and 12.8 s which allows for the addition of one or the other of these durations to cover all durations from 0.1 s to 25.5 s.
  • the identification numbers from 128 to 135 are assigned for the duration values specified above.
  • the identification numbers from 136 to 143 are assigned.
  • the numbers identification from 144 to 151 are assigned.
  • the identification numbers from 152 to 159 are assigned.
  • each constant is stored in registers smart card memories based on identification numbers necessary for the configuration duration entered.
  • the third row of unit blocks of functions of stimulation concerns the frequency of the stimulation pulses.
  • Four values of frequencies A, B, C and D can be entered for all channels in slots 71 of a frequency and amplitude adaptation window 70 seen at the Figure 9a.
  • Said frequency and amplitude adaptation window is opened by selecting a third graphic button 43 of the main window 40 seen in the Figures 5a and 5b.
  • the frequency must be the same for all the channels of stimulation, which means that if a unitary frequency block is introduced into a sequence, it is also applied for all other stimulation channels.
  • the frequency value can be chosen between 0 and 100 Hz in 1 Hz steps.
  • the fourth row of unit blocks of functions of stimulation concerns constants of amplitude to be reached.
  • Four values amplitudes A, B, C and D to be reached can be entered differently for each channel in locations 73 of the frequency adaptation window and amplitude 70 seen in Figure 9a.
  • four sets of different amplitude values each with a determined transition time are introduced for the four channels of stimulation.
  • the numbers 216 to 219 are assigned to each unit amplitude block. More identification numbers of the unit amplitude blocks used for the coded sequences, the data concerning the channel number must also be sent to store the identification numbers in memory locations determined relative to the stimulation channel number.
  • unit blocks for defining repetition loops of Sequences of sequence differently for each stimulation channel are shown.
  • Four kinds of repeat loops A, B, C and D to configure can be placed for each sequence of stimulation data.
  • a loop defined by a single icon is shown in the third row to perform a repeat from the start of the data sequence.
  • Identification number 237 is assigned to the repeat block from the start of the sequence.
  • the first row of FIG. 7b shows the starting unit blocks of the loops A, B, C and D while the second row shows the unit blocks of arrival or marking of loops A, B, C and D.
  • Unit blocks A, B, C and D of the first row can be configured to set the number of repetitions of sequence parts desired. It is quite clear that to repeat part of a stimulation data sequence these unit blocks starting points are placed in sequence positions which must not precede the corresponding unit arrival blocks.
  • FIG. 5a shows for example in the sequence of the first stimulation channel a repetition loop thanks to the unitary starting block A placed in the eighth box and at the unit arrival block A placed in the second box of the sequence.
  • the starting unit block A is configured so that the part of sequence inserted between the two loop blocks must be repeated 7 times.
  • the number of repetitions of a loop can be chosen between 1 time to 255 times.
  • several identification numbers each representing a specific number of repetitions, can define the configuration of each unitary loop start block in each sequence.
  • the determined numbers of repetition of the identification numbers are 1 time, 2 times, 4 times, 8 times, 16 times, 32 times, 64 times and 128 times, which allows by adding one or on the other of these determined numbers to cover the number of repetitions of a loop from 1 time to 255 times.
  • the identification numbers from 169 to 176 of the starting unit block A are assigned for the specified repeat numbers specified above, while the identification number 168 is assigned for the incoming unit block A.
  • the numbers from 178 to 185 of the starting unit block B are allocated for the specified repeat numbers specified above, while the number 177 is assigned to the incoming unit block B.
  • the numbers from 187 to 194 of the starting unit block C are allocated for the specified repeat numbers specified above, while the number 186 is assigned for the incoming unit block C.
  • the numbers from 196 to 203 of the starting unit block D are allocated for the specified repeat numbers specified above, while the number 195 is assigned for the incoming unit block D.
  • loop start blocks When configuring loop start blocks, it can also be choose the value 0 to define that the loop repeats itself indefinitely.
  • the identification numbers defining the repeat loops can be the same for several channels, an indication of the channel number must be transmitted with the coded sequences so that each loop is stored in specific memory registers of the smart card.
  • the positions memories, for each channel, are a function of the identification numbers required to get the desired number of loop repetitions.
  • FIG. 7c different unit blocks for general purposes are shown.
  • the first row concerns four unit blocks A, B, C and D of text used for display a maximum of two lines of text on the screen of a stimulation device during the stimulation sequences of the device. These four Text blocks are defined for all channels in the same way.
  • Identification numbers 233 to 236 are assigned for unit blocks of text in order to occupy determined memory positions on the smart card regardless of the corresponding channel number.
  • two unit blocks A and B of alarm sound are shown in the second row of FIG. 7c. These two alarm blocks A and B can be adapted differently for each stimulation channel with tones or melodies different. This allows to warn for example the moment when a stimulation channel is intended to operate a contraction of certain muscles to be stimulated. Normally in the simplest case, the alarms are adjusted to a low sound frequency for one and higher for the other to differentiate them. Identification numbers 239 and 240 are assigned to these random pulse width variation blocks.
  • a first unit block concerns an absence of stimulation pulses, in each sequence in which it is introduced.
  • the absence of pulses is defined by a period of time fixed during the configuration of said block of no pulses.
  • the duration of no pulses can be set from 0.1 s to 25.5 s.
  • several identification numbers representing the durations 0.1 s, 0.2 s, 0.4 s, 0.8 s, 1.6 s, 3.2 s, 6.4 s and 12.8 s, can be accumulated in a coded sequence to reach the configuration value desired.
  • Identification numbers 160 to 167 are assigned to the durations above.
  • the second unit block in this third row concerns a unit block of delay.
  • This block keeps the last value of pulse width or amplitude of the unit block which precedes the delay block in a sequence in which it is placed.
  • This delay block can be defined by several identification numbers that characterize 1 cycle, 2 cycles, 4 cycles, 8 cycles, 16 cycles, 32 cycles, 64 cycles and 128 cycles to be able to give cumulative 255 cycles in total (25.5 s). Identification numbers from 204 to 211 are assigned for occupy memory positions on the smart card also according to the number of the corresponding channel.
  • the third unitary block of this third row concerns a synchronization unit block which imposes synchronization for all channels stimulation.
  • the identification number 238 is assigned to this unit block of synchronization.
  • unit blocks for stopping or ending sequences are shown.
  • the first unit block placed in any sequence of a stimulation channel allows the device to be stopped or interrupted stimulation.
  • the identification number 230 is assigned to this unit block.
  • the second unit block of this last line is the block at the end of the sequence. It is placed as the last unit block in each data sequence of stimulation. By default, this end of sequence block fills the empty boxes 42 of the sequence rows 41 of the main window 40 seen in FIG. 5a. The number 255 is assigned to this end of sequence block.
  • FIG. 7d unit blocks for special purposes are shown. Both first unit blocks of the first line concern on the one hand the introduction of a random variation of frequency and secondly the interruption of the random variation of frequency. The random frequency variation is done in the same way for all the channels around a determined frequency value. The percentage of variation random can be entered in a slot 72 of the adaptation window of frequency and amplitude 70 seen in Figure 9a. Identification numbers 224 and 225 are allocated to these random frequency variation blocks.
  • the last two unit blocks of the first line of this figure 7d relate on the one hand to the introduction of a random variation in pulse width and on the other hand the interruption of the random variation in pulse width.
  • Variation pulse width is defined around a determined value of width of pulses which can be different for each simulation channel.
  • the percentage pulse width variation can be entered for each channel in slots 63 of the width ramp adaptation window of pulses 60 seen in FIG. 8a.
  • Identification numbers 226 and 227 are assigned to these random pulse width variation blocks.
  • the unit blocks of the second line of FIG. 7d relate on the one hand the introduction of a random variation of amplitude and on the other hand the interruption of random amplitude variation.
  • the amplitude variation is defined around a value determined amplitude. Percentage of amplitude variation can be entered for each channel in locations 74 of the adaptation window of frequency and amplitude 70 seen in Figure 9a. Identification numbers 241 and 242 are allocated to these random pulse width variation blocks.
  • Interaction means any manipulation carried out by a user using sensors or actuators for commands when sequence of each sequence of stimulation data.
  • sensors or actuators are used mainly in the medical field for neuroprostheses in order to control for example the movements and the force or the developed couple of a disabled or injured member.
  • Interaction unit blocks A, B, C, D, E, F and G of the first row relate to actions carried out by a user in the course of the pacing data sequence in which they can be placed.
  • the actions are provided by sensor or actuator measurements which can be connected, for example, to three inputs of a stimulation device, such as the device Compex2, when it is put into operation.
  • This Compex2 device notably includes two inputs for measuring the analog type or digital type that use channels A and B on the back of the device.
  • Another entry designated C for multiple purposes is used on the one hand for the connection for example of a control push button, and secondly for the serial transfer via cable (RS-232) of stimulation data sequences coded established in the computer station. This last entry is also used for powering the device or for electrically charging a device battery.
  • Identification numbers 248 to 254 are assigned to unit blocks Interaction A, B, C, D, E, F and G. As to the type of actuator or sensor chosen for each unitary interaction block, this will be explained below with reference in Figures 10a and 10b.
  • the unit blocks of the second row in FIG. 7e relate to blocks unitary to mark interruptions under the action of a user. These blocks are configured with a unitary interaction block A, B, C, D, E, F or G for all channels in the same way, as shown in the interrupt block 87 of the user interaction adaptation window 80 in FIG. 10a.
  • the first and second ON and OFF interrupt marking unit blocks define on the one hand the starting point in a sequence of the action of a user by example to stop the sequence, and on the other hand the end of a user's action in said sequence. If user interaction has occurred between the first two blocks, a sequence jump is made to the third unit block which defines the position of an emergency routine, for example the end of the sequence. User action to interrupt a sequence cannot therefore be performed in time only between the first two unit blocks.
  • These first two blocks interrupt marking units have the identification numbers 231 and 232.
  • FIG. 7e shows two pairs of unit blocks of branching A and B in a sequence of stimulation data under the action of least one user.
  • Each pair of unit blocks comprises a first block of starting point of the connection and a second block from the arrival point of the connection.
  • a first branching start block can be placed in a first position in a stimulation data sequence followed further by a second branch inlet block placed in a second position of said sequence. While the stimulation data sequence is running, the user has the choice to let the sequence run normally or to pass from the first position to the second sequence position by an action on its part.
  • the block of the starting point of connection A or B is adapted or configured with two different unit interaction blocks A, B, C, D, E, F or G, as represented in the connection blocks by the user 86 of the window adapting user interactions 80 in Figure 10a.
  • a first block of interaction allows skipping the sequence from the first position to the second position, while the second interaction block allows the sequence to continue.
  • Identification numbers 228 and 229 are assigned for each pair of branch blocks or each branch A and B of interaction by the user.
  • FIG. 10a a window for adapting the interactions of a user 80 is shown. Seven user interactions can be adapted in this window 80.
  • This window 80 is opened by pressing a fifth graphic button 43 from the main window 40 seen in FIGS. 5a and 5b.
  • the type of sensor is specified or actuator used. It can be chosen for example an actuator controlled by the stand, which includes force-sensitive resistors, a gyroscope, a push button, a button on the keyboard of the stimulation device, a sensor electromyographic (EMG).
  • actuator controlled by the stand, which includes force-sensitive resistors, a gyroscope, a push button, a button on the keyboard of the stimulation device, a sensor electromyographic (EMG).
  • EMG sensor electromyographic
  • buttons 83 and 84 each relating to a unitary interaction block A, B, C, D, E, F and G, criteria adaptations relating to the type of sensor or actuator can be introduced to set measurement levels for user interaction.
  • a trigger criteria window shown at Figure 10b, appears in particular to define the curve expected to continue the stimulation over time with an electromyographic sensor or other sensors.
  • Short information messages can also be introduced in slots 85 of window 80. In case the trigger criterion is loaded or saved, it is the name of the file that will appear in the small window.
  • FIG 11 shows a window of the amplitude establishment table 90 which is opened by selecting a fourth graphic button 43 from the main window 40 seen in FIGS. 5a and 5b.
  • This window 90 shows four graphs 91 of the four stimulation channels to impose an amplitude on the electrical pulses based on the measurement in sensor voltage.
  • the amplitude of the sensor input signal on the x-axis between 0 and 5V is adapted to the amplitude of the stimulation pulses on the y axis. said sensors are used for voluntary user interaction or for interaction due to the measurement of the muscular response following electrical stimulation.
  • Graphic buttons 92 of each channel can be selected to edit a pulse amplitude ramp to adapt the signal tracing sensors, to save the entered ramp or to load a ramp, which can come from an external text file.
  • Graphic menus 93 make it possible to assign one type of stimulation device input for each stimulation channel.
  • an electrical stimulation device When using an electrical stimulation device as a prosthesis, it is advantageous that its user can control it by valid body parts.
  • the other hand or arm can be used to control said prosthesis using sensors providing dependent electrical responses voluntary muscular action of the valid arm or hand. This allows to impose Hand movements disabled by generation of electrical stimulation.
  • three stimulation channels are required on which a pair of surface electrodes per channel is placed at the places specific for hand action.
  • the patient can regulate the way in which the thumb flexes and the strength of the grip force to allow it to adjust the grip the size and shape of the object he wishes to take.
  • a fourth channel must be used.
  • the control of electrical stimulations for the grasping of the object can be operated by a push button.
  • FIG. 13a and 13b an example of programming data sequences of stimulation in the main window for two stimulation channels and the corresponding PW pulse width graphs are shown in the figures 13a and 13b.
  • Generation of electrical pulses, with variation in width of pulses from both channels, starts and ends based on an interaction of a user UI3, as a function of time.
  • a unitary synchronization block between the two channels requires that the second channel starts these pulse width ramps at the end of the first channel pulse width ramps.
  • the two sequences of stimulation data for both stimulation channels are established to allow a neuroprosthesis placed at the level of a user's hand to make a finger opening and a finger closure.
  • the opening and closing of the fingers is done thanks to the control of a push button actuated by the other hand of the user.
  • the subject can voluntarily, gradually and selectively contract the anterior and posterior branches of a muscle on which it is placed to be able to regulate the EMG activity.
  • it can be placed two sensors EMG on the two branches of the arm opposite to that carrying a neuroprosthesis.
  • the contracted anterior or posterior branch it forces the muscles to the hand of the opposite arm to keep the expected position.
  • the magnitude of the difference between the EMG signals of the anterior and posterior branch is used to control the hand grip force.
  • EMG digital control can be used by patients who cannot gradually regulate EMG signals or cannot maintain muscle contraction for extended periods of time. ON and OFF commands are generated in this scenario to allow the prosthesis to generate appropriate stimulation sequences.
  • a patient can also use push buttons, as described above, to activate the neuroprosthesis.
  • the opening or closing time of the hand with the neuroprosthesis can be fixed beforehand at 2 s.
  • An equivalent principle can be used for people who, for example, have good control of one leg, but whose other requires the aid of an electrically-powered prosthesis. These subjects are typically wheelchair users or people who cannot flex or extend the ankle joint and have weakened controls in the hip or knee joint. On the other hand, patients must have a good sense of balance and be able to remain upright without danger using crutches or supports for walkers. Such a neuroprosthesis thus makes it possible to improve walking performance by generating gait sequences in the damaged leg.
  • Electric stimulation prostheses can be used permanent or for the rehabilitation of a member bruised following an accident, for example.
  • patients who start their training soon after their accident could potentially benefit from the positive effects of training with the device of functional electrical stimulation with surface electrodes.
  • a program sequences of stimulation data on a smart card in this case is performed quickly using the programming facility.
  • support memory can be a floppy disk or a compact disc or an element removable memory other than a described smart card. Said support of memorization could also be an element of the computer station.
  • the number of stimulation channels for establishing the sequences of stimulation data on the computer station may be different from the four channels described.
  • the main window, where the stimulation sequences are composed could depending on the applications include images of the member on which must be placed a neuroprosthesis.
  • the member's vision in the window main would facilitate the realization of stimulation sequences by a person not specialized in this technical field while ensuring that amplitude, frequency or pulse width limit values cannot be exceeded for safety reasons.

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US10765552B2 (en) 2016-02-18 2020-09-08 Zeltiq Aesthetics, Inc. Cooling cup applicators with contoured heads and liner assemblies
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US10952891B1 (en) 2014-05-13 2021-03-23 Zeltiq Aesthetics, Inc. Treatment systems with adjustable gap applicators and methods for cooling tissue
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